Investigators from Europe describe a case report of a patient who experienced skin lesions associated with bed bug infestation and received effective treatment with topical steroids and antihistamines, as published in Dermatologic Therapy.

Bed bugs, brownish insects often found in dark places, bite sleeping humans to obtain blood. In the past 30 years, there has been a resurgence in bed bugs across the globe, which has resulted in increased healthcare costs to patients. Patients bitten by bed bugs rapidly develop highly polymorphic and often linear skin lesions on exposed areas not covered by blankets are sheets. Some patients may experience morning pruritus, erythematous macules and papules between 2 and 5 mm, vesicles, and sometimes purpuric or bullous lesions.

The symptomatic treatment of bed bugs and the manifestations associated with their bites, including pruritus, include the use of topical steroids and antihistamines. Eradication of bed bugs from the home or dwelling in which they infest is another effective adjunct strategy for managing bed bugs; however, things like insect foggers and “bed bug bombs” are typically not effective. Even insecticides may not be sufficient in some cases. Mechanical means, including vacuum cleaning, freezing, and washing, may help improve the efficacy of chemical eradication strategies.

The case reported in Dermatologic Therapy described a 32-year-old man who presented with pruritic erythematous papules and vesicles that affected the neck, forearms, and hands. The patient was seen several times during a 12-month period.


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According to the patient, the recurrence of symptoms was frequently observed when he stayed at his parents’ house. This house was later found to be infested with Cimex lectularius, a common bed bug. Eradication of the bed bugs as well as symptomatic treatment using topical steroids and antihistamines were effective for managing the condition.

The investigators who reported on the case study concluded that the eradication of bed bugs “relies on early detection, and physicians should initiate this process by thinking [of] bed bugs in patients with recurrent and linear skin lesions.”

Reference

Delaunay P, Benzaquen M, Berenger JM, Parola P. Bed bug bites. Published online September 25, 2020. Dermatol Ther. doi:10.1111/dth.14341